Impact of post-procedural change in left ventricle systolic function on survival after percutaneous edge-to-edge mitral valve repair

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Hagnäs , M J , Grasso , C , Di Salvo , M E , Caggegi , A , Barbanti , M , Scandura , S , Milici , A , Motta , G , Bentivegna , A , Sardone , A , Capodicasa , L , Giuffrida , A , Biancari , F , Mäkikallio , T , Capodanno , D & Tamburino , C 2021 , ' Impact of post-procedural change in left ventricle systolic function on survival after percutaneous edge-to-edge mitral valve repair ' , Journal of clinical medicine , vol. 10 , no. 20 , 4748 . https://doi.org/10.3390/jcm10204748

Title: Impact of post-procedural change in left ventricle systolic function on survival after percutaneous edge-to-edge mitral valve repair
Author: Hagnäs, Magnus J.; Grasso, Carmelo; Di Salvo, Maria Elena; Caggegi, Anna; Barbanti, Marco; Scandura, Salvatore; Milici, Annalisa; Motta, Gessica; Bentivegna, Agnese; Sardone, Andrea; Capodicasa, Luigi; Giuffrida, Angelo; Biancari, Fausto; Mäkikallio, Timo; Capodanno, Davide; Tamburino, Corrado
Contributor: University of Helsinki, HUS Heart and Lung Center
University of Helsinki, Department of Medicine
Date: 2021-10-01
Language: eng
Number of pages: 9
Belongs to series: Journal of clinical medicine
ISSN: 2077-0383
URI: http://hdl.handle.net/10138/335879
Abstract: Objectives: To investigate how the changes of left ventricle ejection fraction (LVEF) between admission and discharge affected the long-term outcome in patients who underwent percutaneous edge-to-edge mitral valve repair for secondary mitral regurgitation. Background: An acute impairment of LVEF after surgical repair of mitral regurgitation, known as afterload mismatch, has been associated with increased all-cause mortality. Afterload mismatch after percutaneous edge-to-edge mitral valve repair has been postulated to be a transient phenomenon. Methods: This study is based on a single-center, retrospective, observational registry of patients who underwent percutaneous edge-to-edge mitral valve repair with the MitraClip (Abbot Vascular) system for the treatment of symptomatic, moderate-to-severe mitral regurgitation. We included data on 399 patients who underwent percutaneous edge-to-edge mitral valve repair for secondary mitral regurgitation. Expert echocardiographers assessed LVEF before the procedure and at discharge. The patients were divided into three groups according to the difference of periprocedural LVEF measurements: unchanged (n = 318), improved (n = 40), and decreased (n = 41) LVEF. Results: The median follow-up time was 2.0 years. When adjusted for gender, NYHA class and estimated glomerular filtration rate, decreased postprocedural LVEF was associated with an increased risk of death (adjusted HR 2.05, 95% CI 1.26–3.34) and increased postprocedural LVEF with a reduced risk of death (adjusted HR 0.47, 95% CI 0.24–0.91) compared to unchanged LVEF. Conclusion: Among patients who underwent percutaneous edge-to-edge mitral valve repair, decreased postprocedural LVEF was associated with increased mortality, while improved LVEF was associated with lower mortality compared to unchanged LVEF.
Subject: Heart failure
Left ventricle ejection fraction
MitraClip
Mortality
Secondary mitral regurgitation
3126 Surgery, anesthesiology, intensive care, radiology
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